Women and heart attacks – do you know the symptoms?

Yesterday the boys and I went to a first aid session arranged by the home ed forum I’m a member of. First we learned what to do if someone is choking and then we watched a short video about heart attacks. The video featured a woman who suddenly clutched her chest and staggered around, saying it was probably indigestion, you know, the usual thing we see on TV and in film when someone’s having a heart attack.

But around about this time last year, I heard this reported on the radio:

Fewer women than men suffering from a heart attack appear to experience chest pain symptoms, according to a study of more than one million people in the US.

Overall men have significantly more heart attacks, but under the age of 55 women are more likely to die from one.

Without displaying the classic chest pain symptoms of a heart attack, researchers say some women may not be getting the right kind of treatment.

Dr Kevin F Fox, a consultant cardiologist at Imperial College Healthcare NHS Trust and speaking for the Royal College of Physicians, said that overall the number of heart attacks and associated deaths were falling, but that when young women had heart attacks the outcomes were not good.

“The paper has shown that women, and in particular younger women, under 55 years of age, often do not have the typical presenting symptom of chest pain compared to men when they have a heart attack.

“Although heart attack survival is improving overall, doctors, health care professionals and the public need to be aware and vigilant that women can have a heart attack without the typical chest pain that we all think of as the main symptom.”

It rang a bell with me – I was sure I’d heard that before – so when I got home, I looked it up.

Men: Often the first sign of heart disease is a heart attack itself, a feeling like the chest is being run over by a Mack truck.

Women: Women’s first warning signs are much more subtle and often hard to pinpoint. They may feel fatigue when doing something that they used to do easily, such as play tennis, run to catch a train, change sheets, or walk up two flights of stairs. Sometimes heart disease registers in women as a feeling of mild indigestion. Often there’s no chest pain whatsoever.

So why, seven years later, are we still saying there is? Back to the BBC report:

The US researchers describe the results of their work as “provocative” and urge further study, but say that for the moment there should be no change in the public health message that chest pain and discomfort could be symptoms of a heart attack.

“For the moment.” I’ve been aware of it for seven years, which suggests the health industry has known about it for a lot longer. How much longer does it need to be researched? How many women have died in the meantime? How many women need to die before they change the message?

This is scary, because the symptoms women could have seem so vague and could be anything (and I can see doctors writing this off v easily). My grandma though had very bad chest pain when she had at least one of her heart attacks (don’t smoke, kids!!), so that certainly *does* happen for women. I’ve read before that most medical testing is done on men, so that’s clearly something that needs to change and I wonder if anyone’s campaigning on that.

Oh yes, chest pain can be a symptom for women, but it’s apparently not the most likely and it’s still the one that’s most promoted (if that’s the right word). I’ve read that about medical testing being done on men too, which seems mad. If you read the rest of the Oprah link, there are a lot of issues there that are just plain wrong.

Yes, you’re right. There’s so much information about strokes around these days, it’s about time heart attacks were publicised too. Lots of people are walking around with high blood pressure that they don’t know about and that can cause both heart attacks and strokes. Maybe people should be encouraged to ask their GPs for blood pressure checks as a matter of course? It only takes a couple of minutes, doesn’t need any complex machinery and could be a lifesaver. I know this because I was diagnosed with high blood pressure a few years ago after I’d hurt my shoulder. If I hadn’t had an accident, my blood pressure could now be dangerously high, or I could have already had either a heart attack or stroke. (Or not be here.) My GP prescribed an angiotensin receptor blocker which I may have to be on for life. The very scary thing is that there are no symptoms with high blood pressure but when it gets too high people can have either a heart attack or a stroke. My Mum had four heart attacks in all, starting at age 57, which I thought was quite young. All with chest AND left arm pain.

Thanks for raising this issue. So many people do have a very specific idea of what leads up to a heart attack. The only reason I am very aware of it not being typical for women to have chest pains is that my gran died of a heart attack. She was an alcoholic and had become a recluse by the end so my uncle was actually sleeping in her room to keep an eye on her. He says that she just sat up, said she was going to be sick and lay back down, that was it, he called an ambulance and despite their best efforts at resuscitation she passed away. It resonated with me, not solely because it was my gran, but because I was confused as to why it was deemed a heart attack.

Unfortunately it extends to so many other illnesses, including those that aren’t as instantly fatal. My mum’s friend has just been diagnosed with an agressive bowel cancer and his only symptoms were ongoing fatigue & general malaise which he put down to being busy with work and having 3 young children.

I guess the lesson is to be aware of your own body and push your doctor if they put everything down to hormones, the flu, being run down, etc. If anything goes on too long, it could be something else. That sounds so morose, I don’t mean it to be but it helps to be aware.

Thanks, Leah. So sorry about your gran. You reminded me that one of my mum’s friends died in a similar way – said she wasn’t feeling well, husband went to make her a cup of tea, when he came back with it she was dead.

You’re right re knowing your own body too. Also, women are apparently more likely to let symptoms go on for longer, more likely to dismiss them as ‘nothing’, more likely to be dismissed by doctors. All in all, a pretty poor state of affairs.